Vascular diseases (cardiac events, strokes, peripheral vascular disease) remain the number one killer in Canadian society as well as the leading cause of hospitalization and days spent in the hospital. A 1996 estimate placed Ontario’s vascular disease financial burden at $5.5 billion in total. Any intervention which lowers vascular risk, will have a direct impact on the quantity and quality of life and costs of health care. Further integration of health professionals in teams focused on chronic disease management in individuals and populations is also ripe for further evaluation. Increased collaboration between family physicians, physician specialists, nurse practitioners, and pharmacists are generally thought to be beneficial for patient outcomes, but the literature is inconclusive and their cost-effectiveness is unproven. In addition, combining centralized electronic up-to-date information on the patient’s status with evidence-based recommendations and the ability to communicate either electronically or by phone is expected to result in improved access to care, quality of care, continuity of care and increase cost-effectiveness of chronic disease management.

COMPETE III builds on the researchers' previous work to study an electronic vascular tracking and decision support system shared by patients and their physicians, combined with a clinical care coordinator and automated telephone support system. The researchers are evaluating its impact on vascular risk processes and outcomes, perceived usefulness, ease of use, need for improvement, medication adherence, quality of life and patient goals and motivation.

Study hypothesis: Patients at increased risk of vascular events, if connected with their family physicians, medical specialists and care coordinator via an electronic network (Web, fax and telephone) sharing an intensive tracking, advice and support program, will lower their vascular risk more than those in usual care.

A Randomized Trial of Electronic Integration of Care for Better Vascular Outcomes: The Compete III Study Computerization of Medical Practices for the Enhancement of Therapeutic Effectiveness (COMPETE III)

Further study details as provided by St. Joseph's Healthcare Hamilton:

Primary Outcome Measures:

The comparison of change in vascular monitoring process total score (proportion of process targets met in group) between intervention and control groups.

Secondary Outcome Measures:

Vascular outcome targets

Provider satisfaction, perceived value

Patient satisfaction, self-efficacy, access to care

Health data privacy and security

Patient Quality of Life

Health care utilization

Cost effectiveness

Facilitators, predictors and barriers to the success of project

Scalability and sustainability

Estimated Enrollment:

1000

Study Start Date:

April 2003

Estimated Study Completion Date:

June 2006

Detailed Description:

COMPETE is Canada’s original electronic medical record research network and specializes in the rigorous development, implementation and evaluation of electronic technologies in health care. COMPETE III will build on COMPETE II to incorporate the latest evidence on:

the management of diabetes, hypertension, dyslipidemia and previous vascular events,

improving patient-clinician interactions,

the use of technology to enhance the quality, safety and efficiency of care and

motivational strategies to change both patient and clinician behaviour.

Specifically, the researchers will:

Expand the disease focus to a vascular risk population (diabetes, hypertension, dyslipidemia or previous vascular event);

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00132145